Melatonin Overdose

Written by Alexandra Benisek

• What Are the Recommended Doses of Melatonin?
• What Are the Symptoms of a Melatonin Overdose?
• What Can You Expect With a Melatonin Overdose?
• How Can You Get Help for a Melatonin Overdose?

Melatonin is a hormone that your body makes. It helps you sleep at night. It also comes in an over-the-counter dietary supplement for sleep for adults and kids as pills, creams, gargles, or gels. If you use it for short periods, melatonin should be safe. But experts still have a lot to understand about the supplement. In some situations, a melatonin overdose is possible.

It’s important to understand how to use the sleep aid safely. You should also be aware of the signs of a melatonin overdose.

You can legally buy melatonin in any amount. You don’t need a prescription in the United States. But you can’t get melatonin over the counter in countries like Japan, Australia, the United Kingdom, and some parts of the European Union.

So far, experts haven’t come up with a specific dose or timing for the supplement to help insomnia. Many studies look at doses from 0.1 to 10 milligrams of melatonin. But doctors believe that 2 to 3 milligrams are usually a good amount to start with.

If you’re an adult, you can usually take up to 8 milligrams per day for about 6 months. For kids, experts suggest about 3 milligrams daily for 3 months.

It’s tough to tell exactly how much melatonin each person should take. Everyone’s body may react differently to the supplement based on their:

• Age
• Gender
• Sleep issues
• Health conditions
• Timing when they take melatonin

Studies have also found that sleep aid products may have more or less of the listed melatonin amount. Experts found that certain supplements may have anywhere from under 83% to over 478% of what’s listed on the bottle label. This may mean that you’ve taken more or less of the amount you believe you took. The reason for the poor quality control is that melatonin is considered a dietary supplement. This means that it’s not regulated by the FDA for its indication, potency, or purity.

Too much melatonin can lead to unwanted side effects. But it’s very rare that an overdose of the supplement could kill you. Each form of medication has a lethal dose, or LD 50. This term refers to the amount of supplement that would cause 50% of people to die. Experts haven’t been able to find an LD 50 for melatonin. Very high doses of melatonin weren’t even fatal in animals.

Common melatonin side effects include:

• Headache
• Dizziness
• Nausea
• Drowsiness

If you take too much melatonin, you might have less common symptoms. These include:

• Short-lasting depression
• Mild anxiety
• Tremors
• Stomach cramps
• Irritability
• Less of an ability to be alert
• Confusion or disorientation
• Very low blood pressure

If you take certain medications, you could be at risk of a melatonin interaction. The sleep aid won’t mix well with:

• Anticonvulsants (drugs to treat seizures)
• Anticoagulants and anti-platelet drugs (drugs to prevent blood clots)
• Contraceptive (birth control) drugs
• Diabetes medications
• Immunosuppressants (medications that suppress your immune system)

If you want to start melatonin supplements, ask your doctor first. They can tell you if you’re on any medications that would interact with the sleep aid.

Melatonin can affect your cardiovascular, dermatologic (related to your skin), and central nervous systems. If you have a condition related to one or more of these, you might be at risk of other side effects if you take melatonin.

In addition, if you are older, you may be more sensitive to the supplement. This is because you have a naturally low level of melatonin. So your doctor may suggest that you start with a lower amount of melatonin.

You can also have an allergic reaction to melatonin, but this is rare. In some cases, people may have anaphylaxis, which is a life-threatening allergic reaction, after they use melatonin.

Other signs of an allergic reaction to melatonin may include:

• A skin rash that may have itchy, red, swollen, blistered, or peeling skin
• Wheezing
• Tightness in your chest or throat
• Trouble breathing or talking
• A swollen mouth, face, lips, tongue, or throat

If this happens, you may need to visit the emergency room to get treatment right away.

If you think you’ve taken too much melatonin and begin to have unwanted side effects, don’t worry. Compared to other sleep supplements and medications, melatonin moves through your body very fast. Because of this, its effects don’t last very long.

If you develop slight side effects, try to wait it out a bit and let your body fully process the supplement.

But if the symptoms become strong or you feel concerned, it might be a good idea to call your doctor or poison control at (800) 222-1222. They can help you find the next step or guide you through certain symptoms.

If your child has taken too much melatonin, first make sure that they no longer have access to the supplement. Then, wipe their mouth out with a soft, wet cloth. Don’t try to make them throw up the melatonin that they took.

Afterward, call poison control right away. They’ll help you figure out your treatment options based on how much melatonin your child took.

If you think you’ve overdosed from melatonin or are having an allergic reaction to the supplement, call your doctor, 911, or poison control right away. While it’s rare to have issues with melatonin supplements, it’s better to be cautious if you notice strange side effects from the sleep aid.

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Can You Overdose on Melatonin? How to Determine the Right Dosage

Tossing and turning night after night can take a toll on your mental and physical health. This can make you feel sluggish, irritable, and achy throughout the day. So naturally you might seek a sleep aid for better rest.

Some people see results with over-the-counter and prescription sleeping pills. But before going down this path, consider a natural approach, like melatonin supplements.

“Melatonin is a neurohormone that controls our sleep-wake cycle, and many formulations and dosages are available over the counter,” explains Ofer Jacobowitz, MD, PhD, an otolaryngologist and sleep expert based in New York City. “It can be useful when you are trying to advance your bedtime, especially when combined with reducing light exposure two hours before bedtime.”

Melatonin is naturally produced by the pineal gland and gradually released into your bloodstream as you prepare for sleep. (1) But if your body doesn’t produce enough of this hormone, you may have problems falling asleep or staying asleep. (2)

Melatonin supplement use for one to two months is generally safe for most healthy adults when taken appropriately, but it is possible to overdo it. Read on to learn how to recognize a melatonin overdose.

What Is the Right Dosage of Melatonin: How Much Is Too Much?

Knowing how much melatonin to take is tricky, especially since some brands may recommend a dosage that’s more than your body actually needs. Experts recommend consulting with your doctor to determine the dosage that is best for you. (3)

As you shop around, you’ll find that some melatonin supplements contain as much as 5 to 10 milligrams (mg) per serving. But remember: Over-the-counter supplements are not regulated by the U.S. Food and Drug Administration, so the amount of melatonin actually in a supplement may vary from what is listed.

Generally speaking, most people produce enough melatonin to sleep well. (2) If you need a little extra to reset your sleep cycle, you probably don’t need more than 3 mg. (2) Some people sleep better with as little as 0.3 to 0.5 mg. (5)

Melatonin needs vary from person to person. Since melatonin can have many effects on the body, like all drugs, it should be taken at the lowest dose possible, warns Dr.  Jacobowitz.

It’s best to start with a low amount, and if you still have problems sleeping, gradually step up your dose until you find an amount that improves sleep without causing side effects.

Less is more with melatonin to avoid sleep inertia. (5) This is a common problem with some sleeping pills. Some people complain of a hungover or groggy feeling in the mornings due to remnants of the sleep aid remaining in their bloodstream.

This effect doesn’t typically occur with melatonin, but it can happen if you take too much the night before. (3)

The American Academy of Sleep Medicine recommends that parents consult with physicians before giving a melatonin supplement to a child. (6)

Likewise, if you are pregnant or breastfeeding, talk to your doctor before trying melatonin, as there is not enough research about the potential side effects of melatonin supplements related to pregnancy. (7)

What Medication Can Interact With Melatonin?

It’s important to know how other medicines may interact with melatonin. As a general rule of thumb, consult your doctor before taking any new herbs or supplements. (2)

Melatonin can reduce the effectiveness of some prescription drugs, triggering possibly serious complications.

For example, you shouldn’t combine an anticoagulant or blood thinner medication with melatonin. Melatonin can increase the risk of bleeding. (3)

Melatonin may also increase blood pressure in people who take medication to control their hypertension. (3)

Other drugs that may interact with melatonin include: (3)

• Anticonvulsants
• Contraceptives
• Immunosuppressants and steroids
• Seizure-lowering medication
• Diabetes medication
• CNS (central nervous system) depressants
• Selective serotonin reuptake inhibitors

Also don’t take melatonin if you’ve been diagnosed with an autoimmune disease, such as lupus. (3)

Autoimmune diseases are the result of an overactive immune system, and inflammation is a classic symptom on these diseases. Melatonin can stimulate immune system activity, increasing inflammation and exacerbating an existing disease. (3)

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How to take melatonin correctly: dosage, timing, compatibility

Many have heard about melatonin: it fights insomnia, improves the quality of sleep, and also helps our body adapt when changing time zones.

It would seem that melatonin is a “magic pill” that will make our sleep stronger and healthier. But still, do not forget that melatonin is still a hormone, and in order to really get the maximum benefit from the course, it is important to understand how the supplement works and what mistakes can be made when taking melatonin.

What you need to know before taking melatonin

Melatonin is a substance that tends to accumulate in our body. It begins to be actively produced from 11-12 at night and its concentration decreases closer to 4-5 in the morning, but this is provided that sleep hygiene has been observed.

The main enemy of melatonin is light, and it does not matter if it is of artificial or natural origin. In order to “immerse” our body into sleep and recovery mode, there should be no lighting in the room.

It is known that the concentration of melatonin decreases significantly with age, which is associated with shallow sleep and earlier awakening in the elderly.

When the mode is disturbed, which is associated with a “nightly” lifestyle, the body does not produce enough melatonin. The credit that we take from our body when we are awake at night provokes a decrease in immune defenses, metabolic disorders, and an increase in the concentration of another hormone – cortisol.

The course of melatonin in supplements allows you to even out the natural production of the hormone of the night, thereby improving not only the quality of sleep, but overall health.

How to take melatonin correctly

Several important points should be considered when taking the supplement:

• feature of the action;
• time;
• dosage.

Melatonin is not a sedative drug, it cannot instantly “calm down” the nervous system and make you fall asleep. Additional intake of the hormone allows you to increase its concentration in the body, thereby making it easier to fall asleep in a situation where the conditions for sleep hygiene were observed.

This implies another rule: you need to take melatonin at least 1.5 hours before bedtime , this is exactly how much is needed for the concentration of this hormone to reach the desired level for comfortable falling asleep.

A single dosage of melatonin should not exceed 6 mg. It is best to start with a dosage of 3 mg 2-3 times a week. To combat insomnia, fast-dissolving melatonin (Fast Dissolve) is suitable.

And most importantly, don’t treat melatonin supplements as a “targeted” sleep aid. An additional intake will help to establish a lost regimen for a while and help the body recover, but it is also important to adjust your lifestyle: do not stay up at night, give up any gadgets at least an hour before bedtime, do not overeat, stop smoking and minimize the amount of alcohol.

Melatonin compatibility with other supplements

What can melatonin be combined with? The most popular melatonin combinations are:

• melatonin + magnesium: when taken together, it helps to make falling asleep easier, relieve accumulated tension and alleviate “irritating” factors that can interfere with sleep;
• melatonin + glycine: a combination that helps enhance the effect of each supplement;
• melatonin and tryptophan (5 htp): this combination is possible if tryptophan is taken during the daytime, but it should be remembered that tryptophan is already involved in the synthesis of natural melatonin, so you need to be especially careful in choosing the dosage.

Attention! The article is written for educational purposes, it is not a medical recommendation. Before use, be sure to consult a specialist!

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Melatonin: how to take benefits and side effects

Melatonin is often referred to as the sleep hormone, but this is not entirely true – rather, it is the hormone of the night. It can really help restore sleep, but not in all cases. Studies on the potential of melatonin give conflicting results, but it is generally considered a safe drug. The material was commented on by:

Olga Pyanykh, PhD, endocrinologist, nutritionist at Hadassah Moscow Clinic, Medscan group of companies;

Pakhomova Yulia Alexandrovna, general practitioner, endocrinologist of the multidisciplinary medical center “KDS CLINIC”;

Irina Zavalko, PhD, neurologist-somnologist, leading specialist of the online service for solving insomnia problems Somly.

• What is melatonin
• Melatonin tablets
• Who can and who can’t
• Side effects
• What else will help with sleep problems

What is melatonin

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Melatonin is a hormone the body needs to regulate sleep

© Damir Spanic/Unsplash

Melatonin is a hormone the body needs to regulate sleep. It starts the process of falling asleep. The pineal gland, a gland in the brain, begins to produce it when a person is in the dark and stops when it is brighter – this is the main mechanism of the circadian rhythms. Our retina sends a signal about changes in lighting to the brain. Due to the fact that the length of the day differs in different seasons, the body produces the most melatonin in winter, and less in summer.

“Melatonin is the hormone of the night, not sleep,” explains somnologist Irina Zavalko. “And its hypnotic effect is extremely low. ” It is not melatonin itself that causes the transition to sleep – it simply triggers many biochemical processes that eventually lead to falling asleep. When it becomes light in the morning, the concentration of melatonin drops, the body “cheers up” and wakes up. Therefore, sleep disorders and disturbances in the production of melatonin are often found in people who have to work at night or spend a lot of time behind luminous screens. In addition, often low levels of melatonin occur in older people.

Sleep regulation is just one of the many functions of melatonin. In addition, he:

• regulates the pressure;
• regulates digestion;
• regulates bone growth;
• protects the nervous system from neurodegeneration;
• reduces manifestations of mental disorders, primarily anxiety;
• reduces pain;
• serves as a powerful antioxidant and reduces inflammation.

Today, melatonin is being explored for the treatment of a variety of conditions ranging from mental disorders to reproductive disorders. But there are almost no exact data that allow using it as a medicine [1].

Melatonin tablets

Melatonin is one of the most popular sleep aids. Often people drink it to combat any sleep disorders, and almost always in dosages that are many times higher than necessary. According to one study, 2.1% of Americans took melatonin in the month prior to the survey in 2017-2018 [2]. There are no data on the consumption of melatonin in Russia, but we can safely say that it is quite popular in our country.

Irina Zavalko, PhD, neurologist-somnologist, leading specialist of the online service for solving insomnia problems Somly

Very often people start taking melatonin when they have trouble sleeping on their own, following advertisements or advice from friends. I do not consider taking this drug a problem, because it practically does not give side effects, but very often it pushes back in time or completely replaces seeking the necessary and really effective help.

Melatonin is usually sold in tablets of 0.3 to 5 mg. In general, it is considered safe if taken for a short time, but scientists have too little data on long-term use [3]. For example, one small study showed that a long-term course of melatonin in men can reduce sperm quality [4]. In some countries, it is available by prescription, and in America it is sold as a dietary supplement, not a medicine. In Russia, melatonin and preparations with it are registered medicines.

According to a somnologist, melatonin is not recommended for the treatment of insomnia due to the lack of reliable data on effectiveness – however, like any other drugs.

Olga Pyanykh, PhD, endocrinologist, nutritionist at the Hadassah Moscow clinic of the Medscan group of companies

Taking melatonin just like that is not very reasonable. As a rule, it fights well with disruption of the circadian rhythm of sleep and wakefulness when, for example, we have flights to another time zone or when you had to stay up at night and need to restore the regime.

Studies show that it is most effective to take melatonin for sleep disorders such as [5], [6], [7]:

• general insomnia – melatonin accelerates falling asleep by an average of 30 minutes;
• sleep disturbances in the elderly – these are often associated with a decrease in melatonin production;
• poor quality, superficial sleep;
• delayed sleep phase syndrome – chronotype “owl”, which is a disorder, not a variant of the norm;
• jetlag – biorhythm disorder associated with jet lag;
• sleep disorders during irregular or shift work, when a person has to work in the dark;
• unexpressed sleep problems that are rare or recent;
• sleep disorders in children – but only as a short-term remedy.

According to Irina Zavalko, with severe regular insomnia that occurs more than three times a week, melatonin will definitely not be enough – in this case, you should seek medical help.

Before taking melatonin, be sure to consult with a general practitioner, neurologist, and best of all, a sleep specialist. Doctors often recommend starting with a minimum dose of 0.3 or 0.5 mg. It is quite possible that it will be enough. At the same time, most often melatonin is sold in dosages exceeding these by 10 times.

What’s more, a 2017 Canadian study found that the melatonin content of tablets can be very different from what is advertised. In one of the preparations, the hormone was 83% less than what was written on the package, and in the other, it was 478% more [8]. In general, in 71% of tested drugs, the real amount of melatonin was very different from the declared one. In addition, a quarter of the tablets contained a hormone similar in structure to serotonin, which ended up in them due to insufficient purification, and its excess can cause dangerous poisoning. This is another reason to be especially attentive to the dosage and start with the smallest.

Endocrinologist Yulia Pakhomova recommends taking no more than 2 mg of melatonin per day to normalize sleep. The tablet should be taken no earlier than half an hour before bedtime. When changing time zones, the doctor recommends taking melatonin 3 mg per day the day before the flight and for the next 2-5 days.

Yulia Pakhomova, general practitioner, endocrinologist of the multidisciplinary medical center “KDS CLINIC”

In addition, you should not use melatonin for more than a month. Doctors are afraid of longer use, because there is a big risk that, if you regularly receive a dose of synthetic melatonin, the body will completely stop producing its own.

Who can and can’t take melatonin

Don’t use melatonin for more than a month

© Alexandra Gorn/Unsplash

Melatonin is generally safe. However, doctors do not recommend its use:

• for dementia;
• for depression;
• people with liver and kidney disease;
• suffering from autoimmune diseases;

90,027 dialysis patients;

• pregnant;
• breastfeeding.

Also do not use melatonin together with:

• hypnotics and sedatives;
• anticonvulsants;
• benzodiazepines,
• medicines for pressure;
• anticoagulants;
• oral contraceptives;
• diabetes drugs;
• alcohol;
• immunosuppressants.

Side effects of melatonin

Melatonin is generally considered non-toxic, but can still cause a number of side effects that occur when taken in high doses:

• drowsiness;
• headache;
• rash;
• nightmares;
• gastritis;
• nausea.

The main reason for their appearance is too high a dosage of melatonin.

What else can help improve sleep

The most effective way to treat insomnia is cognitive behavioral therapy

© SHVETS production/Pexels

According to the somnologist, the most effective way to treat insomnia is cognitive behavioral therapy. “This is a comprehensive non-drug approach, consisting of several consultations with a specialist. It is based on current understanding of sleep regulation and includes specific techniques to address sleep-related behaviors as well as dealing with sleep anxiety, changing beliefs that support sleep disorders.”

Endocrinologist Yulia Pakhomova gives recommendations on restoring sleep patterns and fighting insomnia:

• Meditation, breathing practices, self-massage will help you learn to cope with stress – all this should be done in the afternoon or just before bedtime, as well as sports – but only in the morning.
• Set the daily routine – go to bed at the same time, ideally before midnight.
• Sleep at least 8 hours.
• Minimize the use of gadgets and watching TV before going to bed – the blue flickering light of the screen excites the nervous system.
• Take a walk before going to bed, take a warm shower or bath, ventilate the room.
• You can use fragrances with essential oils of mint, lemon balm, lavender, but only natural ones.
• Avoid alcohol, caffeine, strong tea and heavy fatty foods a few hours before bedtime. Dinner should be light, mostly protein, and not too plentiful.
• Instead of tea before going to bed, it is better to drink decoctions of herbs: mint, lemon balm, valerian, St. John’s wort, oregano, motherwort.
• Heating pads in the feet, hands, neck and collar area can help to fall asleep.
• According to the doctor’s prescription, you can try physiotherapy: electrosleep, electrophoresis with a solution of drugs, darsonvalization and hydromassage.